AUGUSTA UROLOGY SURGICENTER LLC NPI 1114984523

NPI Information

NPI: 1114984523
Provider Name: AUGUSTA UROLOGY SURGICENTER, LLC
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 11D0945212

Address:
811 13TH STREET, SUITE 17
AUGUSTA, GA
ZIP 30901
Phone: (706) 724-4111
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AUGUSTA UROLOGY SURGICENTER, LLC is an ambulatory surgical clinic center in Augusta, GA. AUGUSTA UROLOGY SURGICENTER, LLC NPI is 1114984523. The provider is registered as an organization entity type.

The provider's business location address is:

811 13TH STREET, SUITE 17
AUGUSTA, GA
ZIP 30901-700
Phone: (706) 724-4111
Fax: (706) 823-0533

The provider's authorized official is Linda G. Flowers .
The authorized official title is Business Manager and has the following contact phone number (706) 724-4111.

The CLIA number assigned to this NPI record is 11D0945212 - ambulatory surgery center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/28/2006 and was last updated on 1/11/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical	121-153	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00809509A	MEDICAID	GEORGIA
2	111143ASCA	MEDICARE PIN	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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